基于临床流行病学调查心脑合病气虚血瘀证的发病原因

Investigation on Causes of Heart and Brain Disease of Qi Deficiency and Blood Stasis Syndrome Based on Clinical Epidemiology

目的:探讨心脑合病(本文中特指冠心病心绞痛合并动脉粥样硬化性血栓性脑梗死)气虚血瘀证的发病诱因。方法:采用临床流行病学调查的横断面研究方法,在我国11家分中心医院纳入心脑合病患者982例,证名及证素规范化后,运用频数、构成比等方法分析气虚血瘀证在心脑合病发病中的地位;运用卡方检验、logistic回归等统计方法探讨心脑合病气虚血瘀证的发病诱因。结果:①心脑合病组共入选982例,其中常见证型有痰瘀互结、气虚血瘀、风痰阻络、气阴两虚、风痰阻络兼气阴两虚、肝肾阴虚、阴虚阳亢、痰浊中阻、肝阳上亢、风痰阻络兼气滞血瘀、气阴两虚兼血瘀、阴虚血瘀、气血亏虚。其中,气虚血瘀证的频率为8.04%,是本次调查发病证型中较为典型的证型之一。②运用卡方检验对有关心脑合病的30个发病因素进行探索,得出P<0.05的6个指标,分别是外感六淫中的风邪、七情内伤中的怒、五味偏嗜中的辛和咸、喜热食、偏肥甘有统计学意义。③经logistic回归分析得到:过怒、喜热食、偏肥甘、可能是心脑合病气虚血瘀证的发病诱因。结论:本研究表明,过怒、饮食偏肥甘、喜热食可能是心脑合病气虚血瘀证的发病诱因。

Objective：To explore the pathogenesis of combined disease （referred to coronary heart disease and angina pectnris with atherosclerntic thrombotic cerebral infarction） with Qi deficiency and blood stasis. Materml and Method：The clinical epidemiological cross - sectional study method was used. 10 Center Hospitals in China had 982 cases of brain and heart disease. After standardizations of syndrome name and syndrome elements, the frequency and proportion methods were used for the analysis of the deficiency of Qi and blood stasis in the brain and disease. And the chi - square test and logis- tic regression method were used to discuss heart and brain disease with Qi deficiency and blood stasis and inducing factors. Results ： （~）Among a total of 982 cases, the common syndromes were accumulation of phlegm and blood stasis, Qi deficiency and blood stasis, wind - phlegm obstructing collaterals, deficiency of both Qi and Yin, wind - phlegm obstruc- tion combined with deficiency of both qi and Yin, liver and kidney yin deficiency, hyperactivity of Yang due to Yin defi- ciency, phlegm turbid obstructing the middle, hyperactivity of liver - Yang, wind - phlegm obstruction combined with blood stasis, deficiency of both Qi and Yin and blood stasis, deficiency of Qi and blood. Among them, the frequency of deficiency of Qi and blood stasis was 8.04% ,which was the one of the typical syndromes. ②By using the chi - square test on 30 cardiovascular disease risk factors ,there were 6 indexes including wind of six exogenous pathogenic factors, anger of seven emotional injuries, pungent and salt in five flavors, preferring hot food and fat, which the P 〈 0. 05, indicating statistical difference. ③By the logistic regression analysis,it showed that anger, perferring hot food and fat, may be the inducing factors of heart and brain disease of Qi deficiency and blood stasis syndrome. Conclusion：This study shows that anger, perferring hot food and fat may be inducing factors of heart and brain disease of Qi deficiency and blood stasis syndrome.